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Abstract Number: 677

Antibodies to Oxidized Low Density Lipoprotein or Anti-Lipoprotein Lipase May Lead to More Atherosclerotic Plaque in a Sub-Set of SLE Patients

Biji T. Kurien1, James Fesmire2, Skyler P. Dillon3, Marianne Reichlin4, Morris Reichlin5 and Robert H. Scofield6, 1College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 2Oklahoma Medical Research Foundation, 3Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 4Oklahoma Medical Res Fndn, Oklahoma City, OK, 5Arthritis & Imm Laboratory, Oklahoma Medical Research Foun, Oklahoma City, OK, 6Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation; Department of Medicine, University of Oklahoma Health Sciences Center; US Department of Veterans Affairs Medical Center, Oklahoma City, OK

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Atherosclerosis, autoantibodies and systemic lupus erythematosus (SLE)

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Session Information

Title: Systemic Lupus Erythematosus - Human Etiology and Pathogenesis

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Premature atherosclerosis is associated with systemic lupus erythematosus (SLE). Oxidized low density lipoproteins (oxLDL) are important in atherosclerosis and have been reported in SLE in association with anti-phospholipid antibodies. Our earlier work showed increased susceptibility of SLE Patients with anti-Ro 60, La and Ro 52 to develop anti-oxidized LDL. In this study we tested the hypothesis that atherosclerotic plaque will be associated with anti-oxLDL and anti-lipoprotein lipase in a specific autoantibody sub-set of SLE.

Methods: We studied 114 SLE patients and 117 age and sex matched normal controls. Antibodies directed against lipoprotein lipase (ALPL), oxidized low density lipoprotein (anti-oxLDL), and low density lipoprotein (ALDL) were measured by enzme-linked immunosorbent assay. Total cholesterol, LDL, HDL, triglycerides and HDL-Trig were also measured. Plaque was measured by bilateral carotid ultrasound. The study was approved by the Institutional Review Board of the Oklahoma Medical Research Foundation and all subjects signed informed consent forms. The patient population (age range of 16- 87 years; average age 43) was 104 females and 10 males.

Results:

Double immunodiffusion studies showed that sixty three SLE subjects did not have autoantibodies against extractable nuclear antigen (ENA), 14 had antibodies against ribonucleoprotein (RNP), 16 had anti-Ro60, 7 had anti-Ro60/La, 6 had anti-SmRNP, 4 had unidentified precipitin lines and 4 had miscellaneous antibodies. The ENA negative group had a significantly higher plaque measured as carotid intimal thickening (0.9 ± 1.71; p< 0.05) compared to normal controls (0.54 ± 1.26), but did not have significant levels of anti-oxLDL (OD = 0.41 ± 1.62), ALPL (OD = 0.35 ± 0.18) and ALDL (OD = 0.1 ± 0.09) compared to anti-oxLDL (0.165 ± 0.13), ALPL (0.39 ±0.2), ALDL (0.09 ± 0.1) in normal controls. The group with anti-RNP antibodies had significant levels of anti-oxLDL (0.29 ± 0.27; p<0.005) compared to control group. However, the anti-RNP group did not have significant levels of ALPL (0.39 ± 0.19), ALDL (0.14 ± 0.139) or plaque (0.79 ± 1.43) compared to control group. The 16 subjects with anti-Ro60 had significant anti-oxLDL level (0.26 ± 0.15; p<0.003) and plaque (1.29 ± 0.25; p<0.02) compared to controls, but no differences in ALPL (0.36 ± 0.16) or ALDL (0.11 ± 0.11). The 7 SLE subjects with anti-Ro60/La had signficantly higher levels of ALPL antibodies (0.56 ± 0.246; p=0.05) compared to control group. This group had the highest levels of ALPL antibodies compared to all other SLE groups. The anti-SmRNP group did not behave significantly different from normal controls with respect to plaque (0.5 ± 0.55), anti-oxLDL (0.265 ±0.15), anti-LDL (0.14 ± 0.12) or ALPL (0.471 ± 0.27). There was no significant difference in plaque when anti-oxLDL+/ALPL+ or anti-oxLDL-/ALPL- SLE subjects were compared to either anti-oxLDL+/ALPL+ or anti-oxLDL-/ALPL- normal controls.

Conclusion:

Plaque appears to segregate in anti-Ro/La, anti-Ro and ENA negative groups either with or without anti-oxLDL or ALPL.


Disclosure:

B. T. Kurien,
None;

J. Fesmire,
None;

S. P. Dillon,
None;

M. Reichlin,
None;

M. Reichlin,
None;

R. H. Scofield,
None.

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